NRC Fellowship Application

First Name

Last Name

Student ID

City

State/Province

Zip

Gender

Are you a U. S. Citizen?

Yes

Are you a Permanent Resident of U. S.?

Yes

Major

Minor/Option

Cumulative GPA

Graduation date-mm

Graduation date-yyyy

Classification

Do you have a thesis advisor?

Yes, if Yes name of advisor

The topic of your research

Organization

ANS

HPS

INMM

Other

Have you had any research or internship experience?

Industry

National laboratory

University research group

None

Other

Do you know someone or have any family or friend associated with the nuclear industry?

Resume

Personal statement (500 words maximum)

Student Signature

Date

I certify that the information provided on this application is complete and accurate. I understand that providing false, misleading or incomplete information will be the basis for denial or revocation of scholarship funds. I understand that the Office of Student Financial Services reserves the right to modify my award (financial aid/scholarship, etc.) at any time due to changes in my eligibility, enrollment status, housing status, availability of funding; or receipt of any funds not included in my original award.

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